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General NPI Number Information
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NPI Number | 1275515959
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Entity Type | Organization
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Legal Business Name | GREENWOOD PHYSICAL THERAPY CENTER, INC.
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 515 FORREST PARK WAY
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City | GREENWOOD
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State | AR
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Zip | 72936-5955
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Country | US
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Telephone | 479-996-5078
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Fax | 479-996-5079
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Provider Business Mailing Address
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Address Line | 515 FORREST PARK WAY
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City | GREENWOOD
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State | AR
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Zip | 72936-5955
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Country | US
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Telephone | 479-996-5078
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Fax | 479-996-5079
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. PATRICK BRIAN MCCLAIN
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Credential | DPT
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Telephone | 479-996-5078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT2692
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License Number State | AR
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